For each of the ten areas to be reviewed, we have described the journey that is needed in order to make the changes you want to make. The Outcomes Star approach is based on an understanding of the steps that a person must go through: first wanting to make changes and then taking responsibility and changing how they use support.

The ladders show ten noticeable steps. Not everyone starts their journey at step number one, and not everyone finishes at step number ten, but whenever we are making a change we are somewhere on this journey. There are three turning points, highlighted in the following description of the steps.

1. At the beginning of the journey we are not interested in thinking about or discussing that aspect of our lives. Although we are far from achieving our full potential and may be causing harm to ourselves or others, we are cut off and not aware of problems, or unwilling to talk about them. Because of this we are stuck.

2. The first sign of the possibility of change is present when we feel fed up with how things are. This may be fleeting and we are unlikely to engage with workers in any real or meaningful way.

3. We are really fed up with how things are now and want things to be different. Change may seem impos- sible or frightening and we may not know what we want, but we know we don't want to carry on living as we have been. At this point, we will meet workers or others offering to help and accept their help with pressing problems.

4. Here we engage with help in a more consistent way, turning up for (most) appointments and going along with what is agreed. However, we do not take any initiative and rely on others for change. Without workers driving the process we can slip back quickly and may be very critical of workers if things don't work out.

5. The second major turning point comes when we start to look forward and have some idea what we want. We can also see that change won't happen unless we help make it happen. This is an internal change of perspective. There is a sense of being engaged rather than going along with things. This step is essential if we want to make more progress.

6. At this step we are trying new things, doing some things differently and taking some initiative. We have a sense of what we want as well as what we don't want. Moving away from one way of doing things and trying to find another can be frightening and tough. We may feel pulled back. And we may say and do contradict- ory things and need a lot of encouragement and support to move forward.

7. The third key turning point comes when we see for ourselves that making more positive choices and behaving in new ways has a positive effect on what we get and how others respond to us. This can reinforce the choices we make. And after this point, we are more consistent in doing things that are helpful for our journey and get us closer to where we want to be. We may feel a sense of having some control, feel excited about the future and what we could achieve.

8. We are fairly consistently doing things differently in this area of our life. Sometimes this works well, sometimes it does not. We experience setbacks and see that taking responsibility can be difficult at times. We need help to keep our motivation and spirits up during the more difficult times and may be tempted to slip back into old ways.

9. Our ways of doing things in this area of our life are quite well established. We have come through vari- ous setbacks and this has built our confidence. Most of the time we can maintain our behaviour on our own without support but at times of crisis we are vulnerable to slipping back. It can be helpful to have someone who checks that all is well and helps us recognise the danger signs and take action.

10. We have no issues in this area and behave in ways that work well for us and those around us. We don't need any outside help to maintain this way of doing things. We know when we need support and know how to get it. For some ladders, we might find that we are at this point at initial assessment if the ladder is about an issue that isn't relevant for us.

At steps one or two on the Journey of Change we are unlikely to be engaged enough to want to discuss the Outcomes Star with anyone. At nine and ten we are on the last steps towards independence from the service. Most of the big changes happen between points three and eight.

It's important to be aware that the steps on the journey will take different amounts of time for different people.

The Outcomes Star approach is not to tell you or others when changes should happen but to help you and the service to plot them when they do.